HomeMy WebLinkAbout15-16728 . CITY OF ZEPHYRHILLS
, 5335-8TH STREET
(si3)�so-oozo 167 8
BUILDING PERMIT
PERMIT INFORMATION LOCATION INFORMATION
Permit Number: 16728 Address: 5815 9TH ST
Permit Type: RE-ROOF ZEPHYRHILLS, FL.
Class of Work: ROOF REPLACEMENT Township: Range: Book:
Proposed Use: NOT APPLICABLE Lot(s): Block: Section:
Square Feet: Subdivision: CITY OF ZEPHYRHILLS '
Est. Value: Parcel Number: 11-26-21-0010-02500-0100
Improv. Cost: 5,290.00 OWNER INFORMATION
Date Issued: 11/06/2015 Name: GUYSE THOMAS & CHARLENE
Total Fees: 97.50 Address: 5815 9TH ST
Amount Paid: 97.50 ZEPHYRHILLS, FL. 33542
Date Paid: 11/06/2015 Phone: 574-930-6221
Work Desc: REROOF METAL
CONTRACTOR S APPLICATION FEES
A.BARTLETT ROOF N OF C NTRAL F RER F RESIDENTIA 97.50
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Ins ections Re uired
DR IN ROOF INSP
TAPE JOINTS ROOF INSP
FINAL 2 -((9 -l G
REINSPECTION FEES: (c)With respect to Reinspection fees will comply with Florida Statute 553.80 (2)(c)the
local government shall impose a fee of four times the amount of the fee imposed for the initial inspection or
first reinspection,whichever is greater,for each such subsequent reinspection.
NOTICE: In addition to the requirements of this permit, there maybe additional restrictions applicable to this property that
may be found in the public records of this county, and there may be additional permits required from other governmental
entities such as water management, state agencies or federal agencies.
"Warning to ner: Your failure to record a notice of commencement may result in your paying twice for
improve to your properly. If you intend to obtain financing, consult with your lender or an attorney
before recording your notice of commencement."
Comp te ns,Specificatio Must Accompany Application.All work shall be pertormed in accordance with
Ci Codes and Ordinances. NO OCCUPANCY BEFORE C.O.
NO OCCUPANCY BEFORE C.O.
CONT CTOR IGNATURE PERMIT OFFI R
PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
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City of Zephyrhills
BTJILDING PLAN REVIEW C011�MENTS
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Contractor/Horneowner: � ���'"1""� ������ �,
Date Received: / !'`7`"l�
Site: �� � �� �/
Permit Type: �
Approved w/na comrnents: Approved w/the below camments: ❑ Denied wlthe below comments: �
This comment sheet shall be kept with the permit and/ar p1ans.
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Kalvin S itz — s Examiner Date Contractor and/ox Homeowner
(Required when comments are present)
e�s-�aaoo2o City of Zephyrhills Permit Application Fax-813aaaoa7�
8u1lding Department
Date ReGeived ,--- PhonaContac#far Permitting –
t}wner's Name �""'� Owner Phane Number
Owner's Address ��""" � Owner Phone Number � �
Fee Simple Tltleholder Name Owner Phone Number r— � I
(
Fee Simple Titiehotder Address �
i
JOB ADDRESS LOT# C�� i
SUBDIViS10N �— � PARCEL ID# '
(OBTAINED FROM PROPERTY TAX NOTICE)
WORK PROPOSED NEW tON5TR ADDJALI' O ���� O O DEMOLISH
INSTALL 8 REPAIR �
PROPOSED.USE Q SFR Q COMM C� OTHER
TYPE OF CONSTRUCTION � Q BLOCK ` FRAME � STEEL Q
DESCRIPTION OF WQRK
BUILDING 81ZE �— � SQ FOOTAGE HEIGHT C`_�
���j�'��N�' i"5 �,,,, ALUATION�"IJiF TOTAL CONS7RUCTION '
L�e=',_�.� O
QE�ECTRiCA� (y> � AMP SERVICE Q PRQGF2ESS ENERGY Q W.R.E.C.
L ���
QPLUM8ING $ �SA
�vK_ V
'�C
OMECHANICAI $ VALUATiQ(�l OF MECHANICA�.INSTACIATIOt�!
OGAS , Q ROOFlNG Q SPECIA�TY [� OTHEF2
FINISHED FLOOR ELEVATIONS �`� FLOOD ZONE AREA C]YES NO
BUt�DER COMPANl'
SIGNA7URE REGISTERED Y/ N FEE CURRE� Y/N
Address License# �� �
E�ECi'RICIAM COMPANY
SIGNATURE ~' REGISTERED Y J N FEE CURRE� Y/N
Address License# �_ �
PLUMSER COMRANY
SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N
Address License# C �
MECHANICAl. COMPANY
SIGNATURE REGI$TERED Y./ N FEE CURRE� Y/N "
Address Li se#
O'TIiER �"��� /�COMPANY
SIGNATURE �+'REGIS7ERED Y N FEe curtrt�n Y/N
( Addr$ss License# ��
RESlD�NTIAi: At#ach(Z)PlofiPlans;(2}setsaf Buitding Plans;{1)set o#Energy�Forfns;R-0=W Perinit for new construa#ion,
MiMmum.ten(1.0}working'days aRec submittal dake. Requlred onsite,ConstrLctibn Plans;Stormwater Plans w/Silt Fence installed,
Sanitery Facilltles&1.dumpster Site Wo►1oRertnit for subdiVislonsAarge proJects '
CON{MEFLCtAL Attach{3)complete sets af Buildltig PEans plus a I.ife Safety Page;(1)set of Energ}t Forms.R-O-W Perimit far new constniction:`
Minimum ten(10)working days'after submittal date»�Required onsite,ConstrucUon Plans,Stormwater Plans w/Silt Fence instailled,
Sanitary Facilides&1 dumpster._SIte�Work Pertnit for all new proJects.All commercial requlrements must meet compffance ,
SIGN PERMlT Attach{2)'sets of Erig4neerei!'Pfans., .: ' '
""PROPERTY SURVEY required for all NEW construcUan. . , ,
Dirsatlons: -
FIII out applicaUon completely. - , .
Owner 8 Contractor sign back of appltcaUon,notatized
if aver�2500,a Notice of Commencement is required. {A!C upgrades over$7500)
'" Agent(for the contractor)or Power of Attamey(far the owner)would be someone with notarized letter from owner authorizing same
..�:.._..._..,:, ..:_..;.. . .
dVER THE CGUNTER AERM11°fiNG,�..y1.�,(Front of Applicat3on Only)"
Reroofs if shingles Sewens -,,;Service Ijpgredes;A/C ` 'Fenaes(PIoUSurvey/Faotage)
Driveways-Not aver Coun#er if on pubtic r,oadways..needs RQW `
NOTiCE OF DEED RESTRICTIONS:. The undersigned under�tands�;th�t,this;,permit,.may be.subJect to"deed"restNcttons" `
which may-be�more�r.estricttve<th�n County:�regulatlons: �7he=underslgned`assumes r`esponsibili,ty�for°compiiance with any
appNcable.deed restrictions. � �� '*: � ' � , , �» -y--�
UNUCENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES:��If the<owner has��-.hireti: a contractor or
cont�actors to undertake work, they may be:cequired:#o:be;llcensed In accordance,;w(th;state.and•local�regulations. -If the �
contractor (s not Iicensed as�requlred=by law, both the owner and contracto�^-may be•clted for�a�misdemeanor vtolagion
under state law. If the owner or intended>contractor are:uncertaln as to what Iicensing.requlre'ments;may apply:��for=the
intended work, they are advised to contact the Pasco County Building Inspectton Divlston—Licensing Section at 727-847-
8008. Furthermore, If the owner-has hired a contracto� o� contractors, he is advised to have the contractor(s),_�ign
portions of the "contractor Block° of this application for which they will be.responsible. .If you,.as.the owrier"sign�as°the
contractor, that tnay be an indication that�he ts not.properly Iicensed and�Is not entitled to perinitting p�ivileges in Pa�co
County. _ .
TRANSPORTATION::IMPACTIUTIUTIES tMPAC7�ANb RESOU�tCE RECOVERY FEES:��The undersigned understands
that Transportation Impact Fees and.Reco.urse Recove.ry.Fees may�:apply.to:the construction of new buildings,_�change of ' I
use in existing buildings, or�expansion=of-�existi�ig'�buildings; as speclfled.in Pascv County Ordinance number 89-07 and
90-07, as amended. The undersigned also�understands, thait�such fees,�as�rnay_be�.due,;�will.:tie identified at the`tim� of �
permitting. It is furtFier understood that Transportation impact Fees and Resource Recovery=Fees must be paid prior to
receiving a °certificate-of occupancy"--or flnal power.release. :I�the.project,does,hot involvena-.certificate of occupancy or � '
final power release;;the:#ees�must.be paid prtor to permit issuance. Fu�hermore��if:Pascv,County�INater/Sewer(mpact ,
fees are due, they�_must be-pald prior to permit-Issuance-ln accordance witFi�applicable Pasco�-County o�dinances. �
CONSTRUCTION L'IEN LAW(Chapter 713� FlorXda$tatutes�as amended): If valuatlon of work is$2,500.00,or mor�s, I
certify that I, the applicant, .have.,been. proVided with-a-copy�,:af the� "Florfda� Constrttction�:Lien .L'aw .—Homeowner's
Protection Guide" prepared by the Florida Departme�t of Agric.ulture and Consumer Affa(rs. if the applicant Is someone �
other ihan the"owner", I certify.that I have.obtained'�a�copy.of the above.described document°and promise in,good faltFo to ,;
deliver it to the"ownec".prio�•�torcommencement:�� � � ' �� ' _ •
CONTRACTOR'SIOWNER'S AFFIDAVIT: I cei�ti[y,:that all the�informatiqn in�thi�application is accurate and that all w�rk
will�be done in compilance with all.appiicable laws regulating construction, zoning and�land development. Appl(cation is
hereby made to abtain..a permit to :do. work�,and installation as indlceted:.�. ;I ce�tify"that no work�.:or installatton h�as
commenced prior to Issuance of"a permiC and thaC.all work will be pertormed to meet standards of all laws regulat�ng-
construction, County and City codes� zoning regulatiQns, and land development regulatlons�in the jurisdiction. ( also
certify that I unde�stand that the regulations of other government agencies may�apply�to the intended work, and that it is
my responsibility to identify�what.act(ons I must take:to be�in:.corrlpliance: Such agenoles-include but are..not Iimtted to:
- Department of E�lvtronmental=Protection-Cypress. Ba'yhead�, Wetland Areas and Environmentaliy Sensitive
Lands,WatedWastewater Treatment. r
- Southwest Fiorida Water Management :District-Welis, Cypress. Bayheads, Wetland Areas, Altering
Watercourses.
- Army Corps of Engtneers=Seawalls,flocks, Navigable Waterways.
- Department of Health�'& Rehabllitative Serv(ceslEnvironmental Health Unit Welis, Wastewater Treatment,
Septtc Tanks. � ,
- US Envi�onmental�Protection Agency-Asbestos abatement.
Federal Avtatlon.Authority-Runways.
I understand that the following,restrictions'apply to the use of flll:•
- Use of fill is not allowed in Flood Zone"V"unless expressly permitted.
- If the �II materfal is �to be used:'in:�Flood Zone. "A", it. Is understood that a drainage plan address(ng a
°compensating volume"will be submitted at�ime of permitting which (s prepared by a professfonal engineer
Ilcensed by the State of Flortda: ,
- If ihe flll material.Is=to be used In Flood Zone 'A° in�connecfion�with�a permitted building using stem wall
constructfon, I certiry that fill:wall:b.e used only.to.fill the-area wlthin�the�stem wall.
�- If fi�ll material is to be used In any area, I certify that .uee. of such-flll will not adversely affect adJacent
propertles. If use of flll is found to adversely.,�fFect adjacent�properties,.the owner may be cited for vlolating
the conditions of the building:permit Issued•under the:attached permit applicatlon, for lots less than one (1)
acre which are elevated by flll,an engineered drainage plan is required. .
If I am the AGENT FOR THE 01MNER, ILpromise in good fa(th to inform the owner of the�permitting conditions set forth In
this affidav(t prior to commencing construction. I�understand thafi a�-separate permit may be required for elecMcal work,
plumbing, signs, wells, pools, afr conditioning, .gas, or othec installatlons not�spec�Ically lnciuded�in.the application. .A
perm(t Issued shali be constcued to be a Iicense to praceed with the work and not as authority to.vlolate,cancel, alter, �or '
set asfde any provislons of the technical-codes;�nor shall Issuance�of a.permlt.prevent the Bulldirig Official from thereaft�er
,requiring a correction af;errors in.plans, constn�ction or violatlons of any codes. Every permlt issued shail�become invalid
unless the work authortzed by-,such permit;Is-commenced�withln sUc months of permit issuar�ce, ot if work authorized by
the permtt is suspended or` bandoned for a period.of six(6)montF�s.after the time.the�work�ts commenced. �4n extensiun
may be requested, In w ng,_from the Building,Officfal for a period.not�to exceed;ninety.(90)_days_and�will_demonstrate_ _ _-._ -
- --justifiable cause�for.the xtension. �If work cease�:for ninety(90)cons.ecutive:days;..the)ob is. ere.d..abandoned.
WARNING TO O ER: YOUR.FAILURE�TO.,RECORD A,NOTIGE OF�CO C EI�T MAY RESULT IN YOUR
PAYING T1NI E IMPROVEMENTS TO YOUR:PR�OPERTIF. �IF°YO.U� 'D'� 'OBTAIN�FINANCING;'CONSULT
WITH Y U ND O AN.ATTORNEY B FOR�RECO D f� O 'OF' •' E f NT�
FLORIDA JU . 1.17.0 ) ' -
OWNER O E CONTRACTO -
Subscrl d r ed etore me thls Subscribed a m to me ttit�
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Wh isla e onaliy . o e or has/have produced Who Is/a nelly k to me•or has/have•produced •
as Identlflcatlon. es IdenBflcaOon.
Notery Public _ � � '� Notary Public
Commisslon No:' Comnnlssio�i�lo. �
A�4� LB�w=_ Coinmission#FF 150422
Name of Notary typed,printed ar stamped Name of Notary typed " ece er ,
'�;,p��,°.�� Bo ed ltw Troy Fain Insuranea B003B5-7019
a Florida Building Code Online Fage 1 of 2
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AppliCation Type Revision
Code Version 2024
Application Status Approved
Comments
Archived p
Product Manufacturer Mule-Hide Products Co.,Inc, ` •
AddressJFhoneJEmarf I195 Prince Hatl Dr
Beloft,WI 53511-5481 �
.9l (60B)365-3111 Ext809
p��r,O lindareith@trinityerd.com
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Authorized Signature � �+9�' `�i �k�hy McFarland
�,�G� '1�J ��n�i� { h@trinityerd.Cam
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Techntca!Representa ive �1d +Y,� a ��,�''p
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Category ��"°�����'' '� Roofing
Subcategory S� '�Single P}y Roof SysYems
Compliance Method �` Evaluation o
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Flortda Prafessiona}Pngineer
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�iorida Eng�neer or Architect Name who deve]oped Robart N9eminen
the Evaluation Report
Florida License PE-59166
Quality Assurance Entity UL LL.0
Quality Assurance ContracC Expiration Date 06/05/2016 �
Validated By Jahn W.Knezevich,PE
0 Validation Checklist-Hardcopy Received
Certiflcate of Independence R22772 R3 CdI 2015 OS CC7i Nieminen.odf
Referenced Stendard and Year{of Standard} Standard Year
ASTM D6878 2008
FM 4470 1992
FM 4474 2004
TAS 114 2011
Equivalence of Product Standards i
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Sections from the Code
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` 2015159383
ertnil No. Parcel ID No,u Z(A a� ��[� b�S�� Q 1 Q d
NOTICE OF COMMENCEMENT
late of��TI�� _ County o( �I�CJ�C J
HE UNDERSIGNED hereby gives notice lhal improvement will be made to certain real praperty,and in accordance wilh Chapter 713,Florida Slalules,
ie tollowing Inlortnalion is provided in this Notice of Commencement:
Descdption of Property: Parcel Iden6ficatfon No.�1Q� �C1! O b�,,��C7 ��� Q
Street Address: F�
General�escdpl�on of Improvement �1� ��—
Owner Infortnation or Lessee in(ortnation if lfie Lessee contracted for the improvement:
,�gQ /
S�� 7�Lmec� � �eiA�.yY�f(�S
..3 T City Stale
Address � � �•�/) 33��
InteresUnProperty: I�l � AT
Name of Fee Simple Tltleholder'
(If diHerent from Owner lisled above)
Ciry Stale
dress
onlraclor. —1 L I
L "'e U.2� �olUlllfAl�f� ���
r ��ty Slate " /
Addfess cA�2 �7��y�Q� 33 Sy�
Conlraclors Tefephone No.: y �� .J C7 (
Surety;
Name
Rept:1717744 Ree: 10.00 state
nddress DS: 0.00 IT: 0.00
Amountofeond: 5 10/02/2015 D. B., Dp1.y Clerk
Lender.
Name PiiULA 5 0'NEIL.Ph.D.PR5C0 CLERK & COMPTROLLEk
10/02/201926�m 1 3554 S`a�e
nddress OR BK P�
Lenders Telephone No. . .
Persons wilhln lhe Stale of'Florida d'esignaled by the owner upon whom notices or other documenls may be served as provided by
Section 713.13(1)(a)(7),Florida Slalules: '
Name
• Cily Stale
Address
Telephone Number of Designated Person:
o!'`
In addilion lo himself,lhe owner desfgnales
to receive a copy otthe Lienors Notice as providetl in Section 713:t3(1)(b),Florida Statules.
Telephone Numbar of Person or Entity Designaled by Owner.
i, Expiratlon date of Nolice of Comme�cemenl(the expiration date may no1 be before the compietion o(construction and finat payment lo the
contraclor,bul will be one year(rom lhe date of recording unless a differenl date is specified):
ARENCONSIDEREDEMPROPER PAYMENTSDNOERHCH�A.PTER713TPARTE,ESECION��O�3H�ORIDAESTATUTES,�ANDMCAN
RESUIT IN YOUR PAYING N��CE FOR �MPROVEMENTS•TO�YOUR.PROPERTY A NOTICE OF COMMENCEMENT MUST BE
RECORDED AND POSTED ON TF1E:106 SITE•BEFOR&THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN'FINANCING,CONSULT
WITH YOUR LENDER OR AN ATTORNEV BEFORE COMMENCING WORK OR RECORDING.YOUR NOTICE OF COMMENCEMENT
Under penally of perjury,1 deGare that I have read the loregoing nolice of commencement and that[he faGs state e� e irue to lhe best
of my knowledge and belief.
---- �
iTA7E'OFFLORIDA r . �
�OUNTY OF PASCO .�""�"�RICHARD C.BARTLETT ture of O�+ner ar Lessee Owne essee's�Aulhorized
�,�.� Mv COMn�nsS�oN a FFIzo98 Oryicer/Direclor/PartnerlMan er
�'+'o.n�'� ��S:lulyJ1,i017
Signatory s TRIe/OKce J
Z�_ c
� ihe(oregoing instrument vias acknowledged before me Ihi day of �ry0a of authority,e.g..oKcer,lruslee,aHomey in tacQ for
as
(name of party n beh 1 o hom menl was execuled).
�ersonally Known 0 OR Produced 1dAnlificatlon�
Notary Signalure
I enliflcalion P�oduced�' �l�h�� Name(Print)
T e of d
YP
wpdatalbcslnolicecommencemenl_pc053048 ..
i ����� �
STAT�.0� FLORIDA,COUNTY OF PA5C0 ��.j�, A ' � o �'��
THIS IS TG GERTIFY THAT THE FOREGOING IS A �
� . o�d+
TRUE AND CORRECT COPY OF THE DOCUMENT ��n
ON FILE OR OF PUBLIC RECORD IN THIS OFFICE � •, �
WITNESS MY HAND [�OFFICIAL SEALTHIS T� ' �G«t�ve�iu�r, o
'��—DAY OF �2--�� �r � �
.O NEIL,CLERK&COMPTROLLER , . � �
PAULA S � . y8�, ab
BY ��DEPUTY CLERK ' '
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� ��. ��c�tY�tt �.00fi�g �f �C��tr�Y ,�'Yo�ib�c, �1r��.
C/O Richard Bartlett
38408 3rd Ave. � Zephyrhills, FL 33542
(813) 782-5585 � (352) 523-1944 � (813) 973-7737
Lic. #CCC 1325499
One of the Largest, Oldest, Most Dep'endable Roofing Companies in Central Florida
Specializing in Mobile Home White Commercial Rubber, Shing/es & Color Meta!Roofing
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RESIDENT!AL • COMMERCIAL • iVIOBILE HOME
LICENSED -�INSURED - BONDED
• MEMBER OF THE CHAMBER OF COn/IMERCE& BETTER BUSINESS BUREAU •
Serving Zephyrhilis, Dade City, Crystal Springs, Quail Hollow, Wesley Chapel, and Surrounding Areas.
We have re-roofed or repaired more roofs(18,000)in the�past 41 years, than the four local leading roofing companies combined.
We do not charge exfra fees for credit card purchase.Most companies charge 3 to 5%.
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Home Owner
Richard C Bartle ,Pre dent&Owner Bartlett Roofing of Central FL,Inc.
THANK YOU
Your Business is Appreciated.
Payment upon completion unless previous arrangement made.Warranties pertain to original owner
All arrangements contingent upon strikes,accidents or delays beyond our control.Owner to carry fire,tornado and other necessary insurance.
Our workers are fully covered by Workmen's Compensation Insurance.Customer is liable for any charges incurred in collecting this bill.
Rotten wood is an extra$35.00 per sheet(4-ply).Rotten fascia is$2.00 per linear foot. TOt81
r Florida Building Code Online Page 1 of 2
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t � Product Approval
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�_is� �. ^�?�;°`��i;x FL# FL12772-R3
I i<a7"a:n'^.:,w,.��i;.�.���..;•,:,;
Application Type Revision
Code Version 2014
Application Status Approved
Comments
Archived ❑
Produd Manufacturer Mule-Hide Products Co.,Inc.
Address/Phone/Email 1195 Prince Hall Dr
Beloit,WI 53511-5481 -
�.9j�ll'' (608)365-3111 Ext 809
C'`���, linda reith @tri nityerd.com
c�G'�y�1�,�. ,
Authorized Signature ����9��' `"�i thy McFarland
� �,� �1�1� `�YGtin�i h@trinityerd.com
°�'z�'ro �'� ��c�
Technical Representa ive '�A �.,�i �a
Address/Phone/E�ma��� � rif��a��-3
� /� /�'!/ (60�� � ���?' .—
�/�/�oiC� ��� tim.m�� ����m �/
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Quality Assurence Re�n � �C�>��
Address/Phone/Email ��/�� y
♦
Category ��✓p���� � , Roofing
Subcategory � �Single Ply Roof Systems
Com liance Method ���
P � Evaluation Report from a Florida Registered Architect or a Licensed
Florida Professional Engineer
` 0 Evaluation Report-Hardcopy Received
Florida Engineer or Architect Name who developed Robert Nieminen
the Evaluation Report
Florida License PE-59166
Quality Assurence Entity UL LLC
Quality Assurence Contract Expiration Date 06/05/2016 �
Validated By John W.Knezevich,PE
0 Validation Checklist-Hardcopy Received
Certificate of Independence FL.12772 R3 COI 2015 01 COI Nieminen.odf
Referenced Standard and Year(of Standard) Standard Year
ASTM D6878 2008
FM 4470 1992
FM 4474 2004
� TAS 114 2011
Equivalence of Product Standards �' •
Certified By �
Sections from the Code
https://www.floridabuilding.org/nr/nr ann dtl.asnx?naram=w('TF,VXnwtl�asmFRc�l�h9X.__ 7/1�/21115
` Florida Building Code Online Page 2 of 2
Product Approval Method Method 1 Option D '
Date Submitted 03/20/2015
Date Validated 03/27/2015
Date Pending FBC Approval 03/31/2015
Date Approved 06/22/2015
Summary of Products
FL# Model,Number or Name Description
12772.1 Mule-Hide TPO-c Single Ply Roof Thermoplastic polyolefin single ply roof systems
Systems
Limits of Use Installation Instructions
Approved for use in HVHZ:No FLiZ772 R3 II ZO15 03 FINAL AS ER MULE-
Approved for use outside HVHZ:Yes HIDE TPO-c FL12772-R3.odf
Impact Resistant:N/A Verified By: Robert Nieminen PE-59166
Design Pressure:+N/A/-495 Created by Independent Third Party: Yes
Other: 1.)The DP noted in this application pertains to one Evaluation Reports
particular assembly.Refer to the ER appendix for all FL12772 R3 AE 2015 03 FINAL ER MULE-HIDE-
assemblfes and DP's. 2.)Refer to ER section 5 for Limits of TPO-c FL12772-R3.odf
Use. Created by Independent Third Party: Yes
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Contact Us::1940 North Monro tr t.7allaha«oo Fl��zaa phone:850-487-1824
The State of Florida is an AA/EEO employer Coovriaht 2007-2013 State of Florida ::Privacv Statement::Accessfbilitv Statement :Refund Statement
Under Florida law,email addresses are public rerords.If you do not want your e-mail address released in response to a public-records requas[,da not send
� electroni[mail to this entity.Instead,tontact the o�ce by phone or by traditlonal mali.If yau have any questfons,please contact 850.487.1395,xPursuant to
Sedion 455.275(1),Florida Statutes,effective Ottober 1,2012,Iicensees licensed under Chapter 455,F.S.mus[provide the Department with an email address If
they have one.The emaiLs provided may be used for affidal coinmun(cation with the licensee.However email addresses are public record.If you do not wlsh to �'t
suppty a personal address,piease provfde the Department with an emall address which can be made available M the public.To determine if you are a Iicensee under ; {
Chapter 455,F.S.,please click here. 1 /
Praduct Approval Accepts: ��
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SUCUYit.:SitifRiC,Y
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https://www.floridabuildin�.or�/nr/pr at�n dtl.asux?naram=wGEVXOwtDasmFBcODh9X_._ 7/10/2015 I